Emerging drugs for the treatment of tuberculosis

The tuberculosis epidemic continues in much of the developing world fueled by the concurrent HIV epidemic. Due to the emergence of multidrug and extensively drug-resistant isolates of tuberculosis, there is a critical need for new drug regimens for the treatment of this disease. Currently, five new compound classes are in various stages of clinical development for tuberculosis.

Selected literature from the past 5 years was reviewed and the current status of compounds in preclinical development and those compounds undergoing clinical studies in humans is described in detail as well as their known potential limitations. After a > 40-year period of almost no effort to discover and develop new therapeutics for tuberculosis, there are now significant activities by small and large pharmaceutical companies in this area. The reader will understand the current status of agents undergoing clinical evaluation for tuberculosis.

The challenge in antituberculosis drug development is to make available to patients highly effective regimens which present substantial barriers to resistance development in an affordable formulation. Shortening the length of therapy from the current 6 to 3 months or less is a goal for the newly developed regimens. For the first time in many years, there are bright prospects for improving regimens for the therapy of tuberculosis.